What glasses can teach us about insufficient breastmilk

85BF9844-A0BC-4D33-A128-4CB0F2E59303

Vision. It’s arguably the most important of our 5 senses.

It allows us to see a grain of salt, a mountain in the distance and everything in between. It is the key to game hunting, to precision manufacturing, to hitting a home run. It is 100% natural. All human beings are “designed” to see.

Curiously, despite the centrality of vision to our existence and despite the fact that it is natural, the incidence of poor vision is extraordinarily high. Approximately 30% of Americans are nearsighted; approximately 30% of Americans are farsighted; an equal proportion of Americans suffer from astigmatism. These impairments of vision can occur alone and in combination. Indeed, there are many people over age 40 who are both nearsighted, farsighted and have astigmatism.

If vision – a critical bodily function – could require technological assistance more than 50% of the time, why couldn’t lactation also require technological assistance?

What does that tell us?

It tells us that even critical natural functions don’t work properly a large proportion of the time.

It tells us that lactivists like Prof. Amy Brown have literally no idea what they are talking about when they offer claims like this:

There’s a difference between dying from external causes and a part of the body simply not working across a species.

A644FCB0-DEA8-4D44-A85D-BB9003247569

Over 60% of Americans use glasses for vision correction. Nearly 20% use contact lenses for vision correction. That sounds suspiciously like a part of the body — a vital part of the body —simply failing across a large proportion of the species.

If vision – arguably as important as breastfeeding — could require technological assistance more than half the time, why couldn’t lactation also require technological assistance?

We can take the analogy even further:

Are people who need glasses — who have eyes designed to see — not trying hard enough to see? Of course not.

Are they victims of relentless propaganda from Big Glasses and don’t really need vision correction at all? That’s absurd!

Are people who use glasses or contact lenses “giving in” to the inconvenience of not being able to see? How ridiculous!

What about the impact of “unnatural” glasses and contact lenses?

Does a book written by someone wearing reading glasses have less merit than one written by someone with 20/20 vision? No.

Is a touchdown pass drilled to the receiver by a quarterback wearing contact lenses not really a touchdown? No.

If a nearsighted climber summits Mount Everest wearing glasses, is it a lesser achievement than if she had done the same thing without glasses? Absolutely not.

Why not? Because we judge achievements by the outcome, not the process. It makes no difference if someone needs vision correction to complete their activities of daily living or to fulfill their wildest dreams. The achievement is not marred by the need for vision correction.

And, critically, not needing vision correction is not, in and of itself, an achievement.

The same arguments can be made about breastfeeding. Yes, it’s natural. Yes, women are “designed” to breastfeed. Nonetheless a substantial proportion of women and babies will have difficulty with breastfeeding.

Are women with insufficient breastmilk not trying hard enough? Of course not.

Are they victims of relentless propaganda from formula companies and don’t really need to supplement their babies at all? That’s absurd!

Are women who don’t breastfeed abnormal or unnatural? No.

Are woman who choose to formula feed “giving in”? Hardly.

Are babies nourished with formula any less intelligent, talented or valuable than babies nourished with breastmilk? Of course not.

Is raising that baby into a healthy happy child with formula any less of an achievement than doing the same with breastmilk? That’s absurd. The achievement is the healthy, happy baby, not the breastfeeding.

The bottom line is that a home run with vision correction is better than a strikeout without it. A healthy formula fed toddler is better than a stunted toddler who is breastfed.

I understand that there are women who want to view unmedicated breastfeeding as an achievement, but that says more about them and their fragile self-esteem than it says about childbirth or breastfeeding.

I also understand that lactivists like Dr. Amy Brown not only have limited understanding of human physiology, they appear to have no understanding of evolution.

It is the outcome that counts. A great outcome is infinitely more important than a natural process whether that process is vision or lactation. That’s why Fed Is Best!

  • Elodie

    How can lactivists ascertain that low milk supply is a non-existent problem, or at least affects only a small number of mothers, when this concern by new mothers is so easily dismissed?? Lactivists even have the term ‘percieved insufficient milk’ in their arsenal to pressure women to persist in breastfeeding efforts. There is no attempt to investigate the concern, just the reassurance that only 5% of mothers will not have enough milk to exclusively breastfeed. Perhaps this number is a lot higher than touted. But that doesn’t seem to be a consideration.

  • Melissa Wickersham

    At least there are laser eye surgery options for people with vision problems. I have moderate to severe myopia (near-sightedness) and have had it ever since childhood.

    But there aren’t any surgical or medical options that I know of that could grow the missing glandular tissue needed for sufficient adequate lactation. Scientists are learning to grow human organs (like hearts and lungs) synthetically in the lab, but they haven’t approved of an effective way to cure primary lactation deficiencies caused by insufficient glandular tissue.

    If people can’t breastfeed due to underdevelopment or lack of functional glandular tissue , why can’t medical researchers figure out a way to transplant functional glandular tissue to a woman’s breasts if said breasts lack a sufficient amount for lactation?
    Why not culture some stem cells from patients who suffer primary lactation problems due to insufficient glandular tissue? Then we could use the patient’s own stem cells to grow more functional mammary tissue. Basically we would use a patient’s stem cells to clone and generate the glands that they lack.
    Hasn’t anyone in the medical fields thought of this idea?

    • AnnaPDE

      To put it very simply … It’s a lot more complicated to grow functioning organs in the lab than optimistic press releases make it seem; connecting the to-be-implanted glandular tissue to the breast would be very involved, and finally the classical “stem cells just keep growing and turn into cancer” problem is amplified in the case of breast tissue, which undergoes hormone-directed growth and maturation during pregnancy.
      Plus, very practically speaking, by the time you’re done with such treatment the baby is likely finished with bf anyway… So, given that there’s a perfectly viable alternative way of feeding babies, which is widely accessible and tested over decades, I can see why an experimental surgical therapy for lactation issues is less of a focus. The risk benefit ratio doesn’t quite work out.

      • MaineJen

        Yeah, I work in organ transplantation. We are NOT close to growing organs in the lab. There has been experimental success with implanting stem cells onto a lattice of connective tissue and making them “beat” like a heart, but it’s more like a parlor trick than a practical solution at this point. Even more established procedures like pancreatic islet-cell transplant has had…spotty success.

        The wonderful thing about stem cells (they can grow into anything!!) is the same thing that makes them problematic (they can grow into…anything). We simply don’t understand enough about them yet to make them useful.

    • Azuran

      well……it’s unlikely to ever be a thing. Because we already have a very cheap and easy solution to this short term problem: Formula.

      Laser eyes surgery is a LOT cheaper, safer and easier than what you are proposing. And in the long term, is likely to save money and is a ‘generally’ permanent solution to an everyday lifelong problem. Glasses/contacts, and eye exams etc get very expensive over a life time. I pay 400$ for 1 year supply of contact lenses, and about 900$ a pair of glass, and about 30$ a month on cleaning product. And when I die, I will have spend a stupid amount of my live tending my eyes and contact lenses.

      Comparing it with breasfeeding problems, it is only a very punctual and short lived problem. Doesn’t cause any kind of measurable long term repercussion and can be solved with a very cheap, safe and effective option. The risks and costs of such procedures is way disproportionate to the almost nonexistent benefits.

  • Georgie

    If I was a dairy cow the farmer would not even bother milking me. I made next to no milk.

    When I was having difficulties producing more than 1-2 ounces/day of breastmilk the logic I got from IBCLCs was “Since insufficient milk supply happens only 5% of the time. YOU must not be putting your baby to the breast frequently enough/not latching her properly. What you need to do is breastfeed, top up with formula, then pump every 2-3 hours.”

    So I did this for about 5 months and quit once I couldn’t take it anymore. The amount of formula my baby was taking didn’t increase – which showed me that my milk supply never actually increased with all this effort.

    I didn’t do what the IBCLCs said perfectly (sometimes I would sleep for 5 hours if my baby slept) and sometimes my mental health was so bad and I couldn’t continue to struggle to latch my baby (who didn’t want the breast because nothing was really there) because I felt like my baby was rejecting me. But every day I was stimulating my breasts either directly or with the pump at least 8 times.

    The studies I have seen about “perceived” insufficient milk supply have demonstrated that it happens only 5% of the time. But it happened to me and it wasn’t just perceived: little one lost 10% of her weight by day 4 and her jaundice wasn’t getting any better. I never felt my milk come in either.

    I just wish I knew what went wrong. I had hormonal tests a few months before I became pregnant and everything was normal, so I don’t think it’s PCOS. My breasts don’t look hypoplastic. Nursing was always painful for me and I felt completely stressed out after birth (mainly because BFing wasn’t working).

    • Heidi

      I wonder if there is sometimes not a great reason as to why. I am beginning to think it’s just a genetic thing and since we’ve been using substitutes since practically the beginning, enough of us survived with this inability to make breast milk. I don’t have PCOS nor hypoplastic breasts either and I tried my hardest to make milk with little success.

    • NoLongerCrunching

      Wow. Less than 1% of people have diabetes, so I guess if a person shows signs of it, it’s likely just their fault and their pancreas is fine. /s

      • NoLongerCrunching already

      • Sarah

        Less than 5% of the world’s population is American, so I can only conclude that Dr Amy is mistaken about where she lives.

        • NoLongerCrunching

          I’m sure if she tried harder she could be American.

  • Who?

    This is entirely off-topic but is a least-worst style outcome to an outrage:

    https://www.theguardian.com/world/2018/dec/17/el-salvador-rape-victim-freed-imelda-cortez-abortion

    Twenty-four women still in prison though.

  • BeatriceC

    OT Goofy Update: His ABV test came back positive. Avian bornavirus is 100% fatal. Some birds respond to medication that can extend their lives with a reasonable quality of life, however, the new world parrots (amazons and macaws) generally do not. We have had him on several medications just in case, and he has not responded to them at all. He’s objectively gotten worse, as his resistance to being fed has been increasing, to the point where it’s become force feeding, and it’s painful and stressful on everybody, but most of all him. And his is continuing to lose weight in spite of adequate amounts of formula. We have decided to let him go. His appointment is tomorrow afternoon, to give our adult children who live in the area time to get here and say goodbye. https://uploads.disquscdn.com/images/bdff57cfd405d85a090ebfd631b5af9e78dd042977692c42cb04da71a4f08da8.jpg

    • PeggySue

      I am so, so sorry. He’s beautiful and has been so lucky to have you.

    • namaste

      Oh no, oh God, no…….I am so very sorry.

    • Chi

      I am SO sorry to hear that B. It’s heartbreaking to lose a very loved pet and you have my deepest sympathies.

      But you’ve given him a good life and I know that he’ll spend his last time on this Earth surrounded by love.

      Love to you and your family.

    • rosewater1

      I am so sorry to hear that. Goofy knows he is loved. You and yours gave him a wonderful life. I will be thinking of you and sending you love during this painful time.

    • rational thinker

      Very sorry to hear that

    • demodocus

      Ah, Evil Attack Parrot ™, you will be missed.

    • StephanieJR

      I’m so sorry. I’m sure he’s had as happy a life with you as he ever could. What a wonderful bird.

  • fiftyfifty1

    OT: Important paper in JAMA today that debunks the assertion that pregnancy itself, rather than vaginal delivery, is what leads to urinary incontinence. Also it shows that operative vaginal delivery (forceps, vacuum etc) is especially risky for pelvic floor problems.

    Giving birth by CS rather than spontaneous vaginal birth cuts a woman’s risk of urinary incontinence in half and pelvic organ prolapse by even more. Operative vaginal birth compared to spontaneous vaginal birth nearly doubles a woman’s risk of both.

    Would love to see the CS numbers if the CS group had all been prelabor rather than a mixed bag (i.e. included some women who pushed for hours before getting the CS.)

    • Amy Tuteur, MD

      Do you have a link?

      • fiftyfifty1

        I have the paper version:
        Vol 320, number 23, Dec18,2018
        Association of Delivery Mode with Pelvic floor disorders after Childbirth pp 2438-2447

  • StephanieJR

    Everyone in my immediate family wears glasses; myself, my brother, mother, father, uncle, grandmother, and probably a great many distant relatives. Without glasses, I couldn’t read this post, nor write this comment. Without formula, many babies would become brain damaged or dead.

    One of the marks of intelligence is tool use. A stick to get insects, a pair of lenses to correct vision, surgery to save a mother and her child, formulated milk to nourish an infant. Human beings have been adapting and changing their lives for tools since we found need of them. The use of our brains to continue the survival of the species is far more remarkable than the use of our breasts.

  • The Bofa on the Sofa

    I think you should have a guest post by Mel, and let her talk about all the great adventures they have with lactation failure in dairy cattle. You know – animals that are bred for their ability to produce milk? And the failure rate among first time mothers is still 10%….

  • Tbird

    This reminds me a lot of my first birth experience. I had a very textbook, uneventful pregnancy. No complications, gained 18 pounds, no morning sickness, 27 years old. Easy pregnancy and great experience. Until labor.

    I went into labor with only back pain. I had excrustiating back pain and could not stand up straight and had vice grip pressure during contractions. After 12 hours of this labor I was only at 3cm dilated. I decided to get an epidural since it was painful and progressing slowly. After having my water ruptured at 5cm and pitocin to speed things up I finally made it to 10 cm after 24 hours. I had zero urge to push. Baby was still very high up and posterior. I pushed for and hour and half with little progress. Baby’s head would come down with pushes and “suck back up” in between pushes. My husband could see her hair. Iwas given thirty minutes to rest with a peanut ball between my legs to see if baby would rotate and come down more. She did not. OB tried to manually rotate baby from OP to OA and was not successful. I had oxygen and baby started to have non reassuring heart tracings and meconium I’m fluid. C-section was called.

    Natural child birth era have told me everything from “you got an epidural too soon” to “you should have stayed on hands and knees to open your pelvis” to “you didn’t push hard enough or correctly” to “pitocin put your baby in the pelvis in the wrong position” to “you shouldn’t push on your back”, etc. they blame the interventions for the “failure” to have a vaginal birth. But if natural birth is so perfect, why was my baby in a less than ideal position? “Because you reclined on a chair!!” How come baby didn’t come out vaginally after reaching 10cm? “Because you pushed on your back!”

    I’m seeing a theme. Trust natural birth. It’s perfect, except when it doesn’t work out and you need a c-section. If that happens, it’s because of choice YOU made and YOU messed it up. Can’t be that it’s an imperfect process.

    • PeggySue

      Dear God. That sounds hard, and awful. Thank heavens for the epidural and the section that probably saved both your lives. Shuddering at the thought of what you went through. Imperfect process to be sure.

    • Desiree Scorcia

      I had a super similar experuence with my first, except i dialated quickly and needed a section before pushing because my daughter’s heart rate tanked. Everything else was the same (omg back labor! I didnt even feel anything anywhere else. So weird but so paiinful!). I heard the same things tho. NCB pushing friends pointed out ways it was my fault. My feelings are that i lucked out. The section was uncomplicated, recovery was a breeze, and none of the complications of vaginal delivery. I’ll take credit for that if they want to give it to me!!